Vaginal Cancer: Epidemiology and Risk Factors
In situ or invasive vaginal cancer is diagnosed in approximately 1 in 1 lakh women across the globe with a mean age of 60 years for squamous cell cancer. Women may occasionally present in the second or the third decade. Most of the vaginal cancers in young women are primarily HPV related though the other causes could be diethylstilbestrol (DES) exposure, vaginal adenosis, previous radiation therapy, smoking, and HIV/AIDS. Malignancy can be either primary or metastasis from adjacent or distant organs. Primary vaginal cancers are defined as arising solely from the vagina, with no involvement of the ecto-cervix or the vulva distally. According to the International Federation of Gynecology and Obstetrics (FIGO), a vaginal lesion involving the cervix should be managed as a cervical cancer; a tumor involving both the vulva and the vagina should be considered as a primary vulvar cancer. About 80% of vaginal cancers are metastatic with primaries being the cervix or the endometrium and less common sites being the vulva, ovaries, choriocarcinoma, rectosigmoid, and bladder. Metastasis through the blood or lymphatic system can also occur from colon cancer, renal cell carcinoma, melanoma, and breast cancer.
KeywordsVaginal cancer HPV infection VaIN Epidemiology Incidence Risk factors DES exposure
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